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Trentman TL, Fassett SL, McGirr D, et al. Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy. J Robot Surg. 2012;7(3):273-9doi: 10.1007/s11701-012-0379-7.
Trentman, T. L., Fassett, S. L., McGirr, D., Anderson, B., Chang, Y. H., Nateras, R. N., Castle, E. P., & Rosenfeld, D. M. (2013). Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy. Journal of robotic surgery, 7(3), 273-9. https://doi.org/10.1007/s11701-012-0379-7
Trentman, Terrence L, et al. "Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy." Journal of robotic surgery vol. 7,3 (2013): 273-9. doi: https://doi.org/10.1007/s11701-012-0379-7
Trentman TL, Fassett SL, McGirr D, Anderson B, Chang YH, Nateras RN, Castle EP, Rosenfeld DM. Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy. J Robot Surg. 2013 Sep;7(3):273-9. doi: 10.1007/s11701-012-0379-7. Epub 2012 Sep 22. PMID: 27000923.
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J Robot Surg. 2013 Sep;7(3):273-9. doi: 10.1007/s11701-012-0379-7. Epub 2012 Sep 22.

Comparison of anesthetic management and outcomes of robot-assisted versus open radical cystectomy.

Journal of robotic surgery

Terrence L Trentman, Sharon L Fassett, Dustin McGirr, Brad Anderson, Yu-Hui H Chang, Rafael Nunez Nateras, Erik P Castle, David M Rosenfeld

Affiliations

  1. Department of Anesthesiology, Mayo Clinic in Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA. [email protected].
  2. Department of Anesthesiology, Mayo Clinic in Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
  3. Arizona College of Osteopathic Medicine, Midwestern University, Phoenix, USA.
  4. The University of Arizona College of Medicine, Tucson, USA.
  5. Departments of Biomedical Statistics and Informatics, Mayo Clinic in Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
  6. Department of Urology, Mayo Clinic in Arizona, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.

PMID: 27000923 DOI: 10.1007/s11701-012-0379-7

Abstract

Robot-assisted cystectomy surgery may be advantageous for patients. The purpose of this study was to compare anesthetic management and outcomes in patients undergoing robot-assisted versus open radical cystectomy. In a retrospective review of 256 cystectomy procedures, procedure duration, blood loss, respiratory parameters, recovery room opiate consumption, pain scores and antiemetic use in the recovery room, and hospital length of stay were compared. After exclusions, 96 robot-assisted and 102 open procedures were analyzed. Anesthesia and surgery duration were significantly longer in the robot-assisted group, while the length of hospital stay was significantly shorter in the robot-assisted group: 7.1 ± 5.8 versus 9.8 ± 5.03 days, p = 0.0005. Estimated blood loss was 601.8 ± 491.4 ml in the open group versus 257.7 ± 164.3 ml in the robot-assisted group, p < 0.0001. Recovery room opiate consumption was significantly less in the robot-assisted group: 9.5 ± 8.9 versus 12.6 ± 9.9 mg (morphine equivalents), p = 0.02. The highest recorded respiratory rate was significantly higher in the robot-assisted group, as was the highest recorded peak airway pressure. Among patients with arterial blood gas data, the highest arterial partial pressure of CO2 was significantly greater in the robot-assisted group than in the open surgery group: 42.6 ± 5.6 versus 37.4 ± 4.8 mmHg CO2, p = 0.0001. Surgeons and anesthesia providers can expect robot-assisted radical cystectomy surgery to last longer than traditional open surgery, but to be associated with less pain and blood loss. Positioning and abdominal insufflation for robot-assisted surgery may contribute to ventilation challenges.

Keywords: Cystectomy; Opiates; Robot; Robotic surgery; Trendelenburg

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